valtaylor4673
New
Hi Fellow Members,
I am researching and wanted to see if anyone could advise on a few things. I am a new coder/biller and am starting to bill for a pharmacy for injectable drugs. My billing experience has been mostly on the front end(like insurance verification and such) and in home infusion. So, I'm seeking information as to how billing works in a regular pharmacy that will be providing injectable drugs. Please answer these few questions listed below if you have time:
1.Would the pharmacy bill under the patient's medical benefits for the injectables or their pharmacy benefit?
2.The drugs would still be billed on the proper claim form?
3.Is there billing software(like Medisoft) that these injectabes can be billed through?
4.Is there a way to find out which part of their plan would pay the most before billing?
5.Does the pharmacy have to have a contract/contracted rates with the insurance to bill?
I hope you can help. This pharmacy is fairly new to this service and I have a little knowledge and they are seeking more experienced help, but I am trying to get as much info as possible going in to be sure the knowledge I have will be efficient if no other resources are immediately available. I thank you in advance.
Sincerely,
Valarie
I am researching and wanted to see if anyone could advise on a few things. I am a new coder/biller and am starting to bill for a pharmacy for injectable drugs. My billing experience has been mostly on the front end(like insurance verification and such) and in home infusion. So, I'm seeking information as to how billing works in a regular pharmacy that will be providing injectable drugs. Please answer these few questions listed below if you have time:
1.Would the pharmacy bill under the patient's medical benefits for the injectables or their pharmacy benefit?
2.The drugs would still be billed on the proper claim form?
3.Is there billing software(like Medisoft) that these injectabes can be billed through?
4.Is there a way to find out which part of their plan would pay the most before billing?
5.Does the pharmacy have to have a contract/contracted rates with the insurance to bill?
I hope you can help. This pharmacy is fairly new to this service and I have a little knowledge and they are seeking more experienced help, but I am trying to get as much info as possible going in to be sure the knowledge I have will be efficient if no other resources are immediately available. I thank you in advance.
Sincerely,
Valarie